Nursing Elites

1. What is the primary purpose of a patient-centered medical home (PCMH)?

• A. To coordinate all aspects of patient care
• B. To reduce healthcare costs
• C. To implement the latest clinical guidelines
• D. To provide financial incentives for providers

Correct answer: A

Rationale: The correct answer is A: 'To coordinate all aspects of patient care.' A patient-centered medical home (PCMH) aims to provide comprehensive and continuous care by coordinating various aspects of a patient's healthcare needs. While reducing healthcare costs and implementing clinical guidelines are important goals in healthcare, the primary focus of a PCMH is on enhancing patient care coordination to improve outcomes and patient satisfaction. Providing financial incentives for providers is not the primary purpose of a PCMH, although it can be a component of some models to encourage quality care delivery.

2. A nurse is caring for a client who reports difficulty falling asleep. Which of the following recommendations should the nurse make?

• A. Watch a television program in bed before going to sleep.
• B. Drink a cup of hot cocoa before bedtime.
• C. Maintain a consistent time to wake up each day.
• D. Exercise 1 hour before going to bed.

Correct answer: C

Rationale: The correct answer is C: "Maintain a consistent time to wake up each day." Establishing a regular wake-up time helps regulate the body's internal clock and promotes better sleep patterns. Watching television in bed (Choice A) can actually hinder sleep due to the light emitted by screens affecting melatonin production. Drinking beverages with caffeine like hot cocoa (Choice B) close to bedtime can interfere with falling asleep. Exercising vigorously right before bed (Choice D) can increase alertness and make it harder to fall asleep.

3. What is the term used for assigning a rating based on an overall impression?

• A. Recency error.
• B. Leniency error.
• C. Absolute judgment.
• D. Halo error.

Correct answer: D

Rationale: The correct answer is 'Halo error.' Halo error occurs when a rating is given based on a general impression rather than specific performance criteria. Choice A, 'Recency error,' refers to rating an employee based on recent events rather than the entire evaluation period. Choice B, 'Leniency error,' is when a manager consistently rates employees higher than they deserve. Choice C, 'Absolute judgment,' involves evaluating based on established standards rather than an overall impression.

4. An RN is working through an ethical dilemma involving a patient on his unit. He has just identified the decision makers involved. Which step best describes the current stage the RN is working through?

• A. Assessment
• B. Diagnosis
• C. Planning
• D. Implementation

Correct answer: C

Rationale: The correct answer is C: Planning. In the planning phase of addressing an ethical dilemma, the goals of treatment are established, decision makers are identified, and all available options are reviewed. The assessment phase involves collecting data and information, the diagnosis phase involves analyzing the information to identify the problem, and the implementation phase involves carrying out the chosen plan of action. Therefore, in this scenario, where decision makers are being identified, the RN is in the planning stage.

5. 1. To monitor for complications in a patient with type 2 diabetes, which tests will the nurse in the diabetic clinic schedule at least annually (select one that doesn't apply)?

• A. Blood pressure
• B. Serum creatinine
• C. Chest x-ray
• D. Urine for microalbuminuria

Correct answer: C

Rationale: The correct answer is C: Chest x-ray. While monitoring for complications in a patient with type 2 diabetes, annual tests such as blood pressure measurement, serum creatinine levels, and urine for microalbuminuria are essential. These tests help in assessing kidney function, cardiovascular health, and early signs of kidney damage, which are common complications of diabetes. A chest x-ray is not routinely scheduled annually to monitor for complications related to type 2 diabetes, making it the least applicable option.

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